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India's Sanitation for All: How to Make It Happen

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India's Sanitation for All: How to Make It Happen 1 Series India’s Sanitation for All: 18 How to Make it Happen INDIA’S SANITATION FOR ALL How to Make It Happen © 2009 Asian Development Bank All rights reserved. Published 2009. Printed in the Philippines. The views expressed in this book are those of the authors and do not necessarily reflect the views and policies of the Asian Development Bank (ADB) or its Board of Governors or the governments they represent. ADB does not guarantee the accuracy of the data included in this publication and accepts no responsibility for any consequence of their use. By making any designation of or reference to a particular territory or geographic area, or by using the term “country” in this document, ADB does not intend to make any judgments as to the legal or other status of any territory or area. ADB encourages printing or copying information exclusively for personal and noncommercial use with proper acknowledgment of ADB. Users are restricted from reselling, redistributing, or creating derivative works for commercial purposes without the express, written consent of ADB. 6 ADB Avenue, Mandaluyong City 1550 Metro Manila, Philippines Tel +63 2 632 4444 Fax +63 2 636 2444 www.adb.org For orders, contact Department of External Relations Fax +63 2 636 2648 [email protected] Contents 3 7 India’s Sanitation for All: How to Make It Happen 9 Sanitation in India: How Bad is It? 12 Making Household Sanitation an Investment Priority 15 Finding Optimal Solutions 23 Moving Forward Acknowledgement 5 The study Sanitation in India: Progress, Differentials, Correlates, and Challenges (2009) was done by Sekhar Bonu and Hun Kim. Jeffrey Bowyer developed the report based on the findings of the study. Additional inputs and comments were provided by Sekhar Bonu, Anand Chiplunkar, Maria Corazon Ebarvia, Maria Christina Dueñas, Robert Hood, and Ellen Pascua. The following helped in the finalization of this publication: Keech Hidalgo, Josef Ilumin, and Gino Pascua. INDIA’S SANITATION FOR ALL How to Make It Happen 7 roviding environmentally-safe sanitation to millions of people is a significant challenge, especially in the world’s Psecond most populated country. The task is doubly difficult in a country where the introduction of new technologies can challenge people’s traditions and beliefs. This discussion paper examines the current state of sanitation services in India in relation to two goals—Goal 7 of the Millennium Development Goals (MDGs), which calls on countries to halve, by 2015, the proportion of people without improved sanitation facilities (from 1990 levels); and India’s more ambitious goal of providing “Sanitation for All” by 2012, established under its Total Sanitation Campaign. ADB Photo Library The sanitation problem is most evident in urban poor and rural communities, and affects women and children in particular This paper discusses six recommendations that can help key stakeholders address the significant obstacles in providing universal sanitation coverage in India. These recommendations, listed below, are based largely on a recent Asian Development Bank (ADB) study—Sanitation in India: Progress, Differentials, Correlates, and Challenges—that looked at trends in access to household sanitation and drainage in India. 1) Successful pro-poor sanitation programs must be scaled up. Assistance is still not reaching large numbers of the poorest of the poor. Successful models must be replicated and scaled up to serve those who cannot provide for their own needs under existing 8 service delivery systems. 2) Investments must be customized and targeted to those most in need. With more than 450 million Indians living below the poverty line, only a few of the poor who have inadequate sanitation can be assisted right away. Due to limited resources, programs should target groups or locations lagging behind the furthest. 3) Cost-effective options must be explored. Appropriate lower-cost solutions offer a safe alternative to a wider range of the population. Higher-cost options can be explored when economic growth permits. Regardless of cost, all systems should address sanitation all the way “from toilet to river.” 4) Proper planning and sequencing must be applied. Investing in incremental improvements is an approach that one could consider if affordability of sanitation investment is an issue. Careful planning is required to ensure that investments do not become wasteful and redundant. 5) Community-based solutions must be adopted where possible. An approach known as Community-Led Total Sanitation (CLTS) has been found to be effective in promoting change at the community level. Efforts must address sociocultural attitudes toward sanitation and involve women as agents of change. Another innovation is the socialized community-fund raising, which has met great success among the rural poor. 6) Innovative partnerships must be forged to stimulate investments. The key is to stimulate investments from as wide a range of sources as possible, including the private sector, nongovernment organizations (NGOs), and consumers themselves. This may require working with a wide range of partners through innovative public–private partnerships. In making these recommendations, this paper targets designers and implementers of sanitation programs in India, as well as those who make policies that advance the sanitation cause. This may include people within government ministries, state and local governments, and nongovernment organizations. It also includes development agencies like ADB, which have the ability to wield significant influence in the sector. India’s Sanitation for All: How to Make It Happen All: Sanitation for India’s SANITATION IN INDIA How Bad is It? 9 he report Asia Water Watch 2015 projected that India will likely achieve its MDG sanitation target in both urban Tand rural areas if they continue expanding access at their 1990–2002 rates. By 2015, the percentage of people in urban areas served by improved sanitation1 is expected to reach 80%, up from 43% in 1990. In rural areas, the projection is 48%, an incredible improvement over the coverage rate of just 1% in 1990.2 In real numbers, that means more Indians will have improved their sanitation situation from 1990 to 2015 than the total number of people currently residing in the United States—quite an achievement. ADB Photo Library Untreated sewage and uncollected solid waste block drainage and pollute waterways However, while India may be “on track” in achieving the MDG sanitation target, it is important not to be complacent. MDG goals simply represent achievable levels if countries commit the resources and power to accomplish them. They do not necessarily represent acceptable levels of service. This is especially true for India’s sanitation situation. Despite recent progress, access to improved sanitation remains far lower in India compared to many other countries with similar, or even lower, per capita gross domestic product. Bangladesh, Mauritania, Mongolia, Nigeria, Pakistan, and Viet Nam—all with a lower gross domestic product per capita than India3—are 10 just a few of the countries that achieved higher access to improved sanitation in 2006.4 An estimated 55% of all Indians, or close to 600 million people, still do not have access to any kind of toilet.5 Among those who make up this shocking total, Indians who live in urban slums and rural environments are affected the most. In rural areas, the scale of the problem is particularly daunting, as 74% of the rural population still defecates in the open.6 In these environments, cash income is very low and the idea of building a facility for defecation in or near the house may not seem natural. And where facilities exist, they are often inadequate. The sanitation landscape in India is still littered with 13 million unsanitary bucket latrines, which require scavengers to conduct house-to-house excreta collection. Over 700,000 Indians still make their living this way.7 The situation in urban areas is not as critical in terms of scale, but the sanitation problems in crowded environments are typically more serious and immediate. In these areas, the main challenge is to ensure safe environmental sanitation. Even in areas where households have toilets, the contents of bucket-latrines and pits, even of sewers, are often emptied without regard for environmental and health considerations. Sewerage systems, if they are even available, commonly suffer from poor maintenance, which leads to overflows of raw sewage. Today, with more than 20 Indian cities with populations of more than 1 million people, including Indian megacities, such as Kolkata, Mumbai, and New Delhi, antiquated sewerage systems simply cannot handle the increased load. In New Delhi alone, existing sewers originally built to service a population of only 3 million cannot manage the wastewater produced daily by the city’s present inhabitants, now close to a massive 14 million.8 1 “Improved sanitation facilities” are defined under the MDGs as those that ensure hygienic separation of excreta from human contact. This includes connection to a public sewer, connection to a septic system, pour-flush latrine, simple pit latrine, and ventilated improved pit latrine. Sanitation solutions not considered "improved" include: public or shared latrine, open pit latrine, and bucket latrines. 2 ADB, UNDP, UNESCAP, and WHO. 2006. Asia Water Watch 2015: Are Countries in Asia on Track to Meet Target 10 of the Millennium Development Goals?. Manila. 3 As measured by purchasing power parity (current international $). 4 World Development Indicators. 2006. 5 Bonu, Sekhar and Hun Kim. May 2009. Sanitation in India: Progress, Differentials, Correlates, and Challenges. ADB. Based on author’s analysis of the 2005 National Family Health Survey. 6 Ibid. 7 Dueñas, Christina, April 2008. Crusading for Human and Environmental Dignity. www.adb.org/Water/Champions/pathak.asp. 8 Tigno, Cezar. April 2008. Country Water Action: India, Toilet Technology for Human Dignity. ADB. India’s Sanitation for All: How to Make It Happen All: Sanitation for India’s Wastewater treatment capacity is also woefully inadequate, as India has neither enough water to flush-out city effluents nor enough money to set up sewage treatment plants.
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